Tip of the Month - April
5 April 2019
The Coughing Dog
How often do you see an old dog with a cough which just doesn’t seem to respond to antibiotics? It’s not that often, but when you do, there’s a certain sinking feeling when you realise you finally have to take thoracic radiographs and there is a very real chance that a lung mass will be present.
The big problem with these cases, though, is that we take the radiographs too late.
There is a massive difference in prognosis between dogs with a small to medium-sized pulmonary mass and those with a larger tumour or one which has infiltrated the pleura.
This graph is taken from a paper that demonstrated unequivocally the marked difference in outcome achieved when dogs with lung tumours underwent surgery if they were diagnosed before the primary tumour got too large. MST stands for median survival time, i.e. average life expectancy. On the basis of this study, we very rarely operate on cases that are designated anything other than clinical stage 1. Fortunately, we have other medical approaches for those patients. So, the clear message is this:
With a coughing dog, radiograph early!
A speculative course of antibiotics is appropriate. But one course is plenty. If there is only limited improvement after one 7-10 day course, or if there is significant improvement but relapse within 3-4 weeks, radiograph. Do not trial another course of therapy first. Early radiography could mean the difference between a resectable mass and a non-resectable mass